Claims Processing Administrative Coordinator

2 weeks ago


Jacksonville, Florida, United States The Doctors Company Full time

The Doctors Company is in search of a Claims Processing Administrative Coordinator to enhance our operational team.

This role is pivotal in guiding members and callers through the necessary steps to gather essential documentation for the creation of electronic claim files. The specialist will also offer clerical and technical support to the claims staff, ensuring precise and timely updates to coding and files, which are crucial for data warehouse inquiries related to claims processing and research initiatives. The position involves interactions with a diverse range of contacts, including employees, member physicians, agents, brokers, vendors, defense attorneys, administrators, and patients, all under direct supervision.

Qualifications

  • A Bachelor's degree or a relevant combination of education and experience is required.
  • Experience in the insurance or healthcare sector is preferred.
  • Exceptional oral and written communication abilities.
  • Strong organizational skills and meticulous attention to detail.
  • Proficient customer service skills and a capacity to thrive in a high-performance team environment.
  • Ability to adhere to departmental procedures with a high level of accuracy.
  • Capability to prioritize tasks effectively to meet deadlines.
  • Proficient in handling confidential health information in line with company policies.
  • Aptitude for supporting diverse internal and external stakeholders.
Responsibilities

Collaboration & Support
  • Engages with insured members professionally to ensure optimal outcomes.
  • Interacts with both internal and external customers proactively.
  • Utilizes internal resources for effective problem resolution.
  • Collaborates actively within the claims department and across other departments to enhance customer engagement.
  • Provides ongoing support to stakeholders throughout the claims process.
Claims Documentation & Management
  • Maintains a comprehensive understanding of company standards and guidelines.
  • Communicates guidelines to stakeholders as necessary.
  • Aims to meet and exceed company and departmental standards.
  • Employs sound judgment in applying guidelines to achieve favorable outcomes.
  • Monitors and approves fees and expenses to align with company and statutory guidelines.
  • Assesses attorney performance and informs supervisors of any necessary improvements.
Member Services
  • Delivers clear communication to members and follows up as required.
  • Maintains awareness of members' needs to provide appropriate support.
  • Escalates member concerns to management when necessary.
  • Produces high-quality work that streamlines downstream workflows.
Policy Compliance & Development
  • Adheres to all established policies and procedures.
  • Identifies areas for improvement and service enhancements.
  • Actively addresses compliance issues as they arise.
Additional Responsibilities
  • Contributes to process improvement initiatives.
Salary Range: $47,901 - $59,172

Compensation is determined based on skills, knowledge, and educational background, ensuring equitable and competitive pay.

Benefits:

The Doctors Company provides a competitive compensation package, including incentive bonuses, exceptional career opportunities, and a comprehensive benefits package that includes medical, family, and bereavement leave; domestic partner benefits; short- and long-term disability programs; and an employee assistance program. Additional benefits include:
  • Health, dental, and vision insurance.
  • Health and dependent care tax-free spending accounts with company matching.
  • 401(k) and Roth IRA with company matching.
  • Paid vacation, sick days, and personal days, with increases based on tenure.
  • 11 paid holidays annually.
  • Life and travel insurance.
  • Tax-free commuter benefits.
  • Opportunities for in-person and online learning.
  • Cross-functional career development.
  • Business casual work environment.
  • Volunteer time off.
  • Matching donations to qualifying non-profits.
  • Company-sponsored participation in non-profit events.
About The Doctors Company

The Doctors Company is the largest physician-owned medical malpractice insurer in the nation. Founded and led by physicians, we are dedicated to advancing, protecting, and rewarding the practice of good medicine.

The Doctors Company is proud to be Certified™ by Great Place to Work.

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